Inpatient Coding Auditor, Senior Associate- Remote

Gainwell Technologies LLC•Any city, OH

1d•$54,100 - $77,300•Remote

About The Position

We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately document findings, and provide policy/regulatory support for determinations. The candidate must have an extensive background in either facility-based inpatient coding and/or outpatient coding edits and a high level of understanding of reimbursement guidelines, specifically the MS-DRG, AP-DRG, APR-DRG, ASC, and APC payment systems.

Requirements

One or more active professional credentials through AHIMA or AAPC (CPC, CCS, COC, RHIA, RHIT); required.
2+ years of experience in inpatient medical record coding and/or auditing; required.
Demonstrated proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodologies.
Demonstrates a thorough understanding of APR-DRG, AP-DRG, and MS-DRG.
Demonstrated experience in medical record coding and auditing.
Demonstrated proficiency in computer skills and typing, including Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, and virtual meeting tools such as Microsoft Teams and Zoom.

Responsibilities

Performs audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCCs and CCs) and procedure codes.
Validates the assignment and sequencing of ICD-10 codes, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment.
Adheres to official coding guidelines, Coding Clinic guidance, and regulatory mandates.
Draws on advanced ICD-10 coding expertise to substantiate conclusions.
Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
Consistently achieves productivity and quality performance standards established by management.
Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce that meets client needs.
Assists management with training new Coding Auditors, including daily monitoring, mentoring, feedback, and education.
Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
Responsible for attending training sessions and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.